The aim of the study is to evaluate the effect of hyperinsulinemia and postprandial changes in plasma glucose and lipids concentrations on the endothelial function together with other metabolic parameters in patients with type 2 diabetes (T2D) and in healthy subjects. Hypothesis: Different changes in endothelial function to acute in vivo induced hyperinsulinemia and after the meal test will be found in patients with T2D compared to healthy subjects. A significant relationships between insulin sensitivity, selected adipokines intramyocellular fat content, hepatic fat content and high energy phosphates in soleus muscle will be documented in both groups.
30 patients with T2D and 30 healthy control subjects will be examined on an outpatient basis. The following examination will be carried out in each subject after 12 hrs fasting: * Hyperinsulinaemic euglycemic clamp study lasting 4 hours combined with indirect calorimetry and biopsy of subcutaneous adipose tissue and muscle aspiration biopsy * Meal test:Plasma glucose, immunoreactive insulin, plasma lipids, oxidative stress markers and gastrointestinal peptides measured in response to a standard meal(at times 0´,30´,60´,120´,180´) * At the beginning and after 120 minutes during the meal test and clamp peripheral microvascular endothelial function will be measured using EndoPat(Itamar Medical) * Proton and phosphorus magnetic resonance spectroscopy(MRS). * Dual Energy X-ray Absorptiometry(DXA) scanning to measure body composition.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
BASIC_SCIENCE
Masking
NONE
Enrollment
60
Baguette Cheese Gourmet (Crocodile: 180g, energy 452.8 Kcal, composition: carbohydrates 49,2 g (44,55%), proteins 18,5 g (16,74%), lipids 18,8 g (38,7%), of which saturated 6,8 g, monounsaturated 6,0 g, polyunsaturated 5,0 g.
Hyperinsulinemic (1mU/kg/min) euglycemic clamp 3 hours long
Diabetes Center, Institute of Clinical and Experimental Medicine
Prague, Czechia
Changes of endothelial function (measured by EndoPat)
at 0 and after 120 minutes during the clamp and 120 minutes after meal ingestion
Time frame: 120 minutes
Changes in gastrointestinal peptides concentrations
0, 30, 60, 120, 180 minutes after meal ingestion
Time frame: 180 minutes
Changes in oxidative stress markers
at 0 and after 120 minutes after meal ingestion
Time frame: 120 minutes
Insulin sensitivity measured as glucose disposal during clamp
Time frame: 4 hours
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